Facemask Use Research Articles

Enhancement of Hand Hygiene and Face Mask Use during COVID-19 Pandemic amongK-12 Schools’ Teachers

Enhancement of Hand Hygiene and Face Mask Use during COVID-19 Pandemic amongK-12 Schools’ Teachers

THE IMPACT OF DELAY STRATEGIES ON THE DYNAMICS OF CORONAVIRUS PANDEMIC MODEL WITH NONLINEAR INCIDENCE RATE

Currently, the world is facing a devastating pandemic of a novel coronavirus, which started as an outbreak of pneumonia of unknown cause in Wuhan city of China in December of 2019. According to the recent report of the World Health Organization (WHO), 210 countries convicted badly 1.8 million infections and almost 200,000 causalities. Due to the non-availability of the vaccination, delay strategies such as community distancing, travel restrictions, extension in breaks, use of face-mask, and self-quarantine are the effective treatments to control the pandemic of coronavirus. So, we proposed the delayed susceptible-exposed-infected-recovered model with a nonlinear incidence rate to study the effective role of control strategies. For this analysis, we discussed three types of equilibria of the model such as trivial, coronavirus free, and coronavirus existence with delay terms. The local and global stabilities are investigated by using well-posed notations like the Lasalle invariance principle, Routh–Hurwitz criterion, and Lyapunov function. In the end, some useful replications are presented.

Use of facemask during the COVID-19 pandemic in Southeastern Nigeria: an observational study

The use of facemask for the control of the spread of the novel corona virus among the population has been recommended by the health authorities. This is as a result of its effectiveness in the control of various infectious respiratory diseases during past epidemics and pandemics. This observational study was carried out to assess the frequency of use, appropriateness of application, type, and the quality of the used facemasks among the residents of southeastern Nigeria during the COVID-19 pandemic and to be able to draw inference from this observation on whether facemask usage can aid in controlling the spread of the disease in the study area and the country at large. Using a two-stage sampling technique, a total of 3100 individuals were observed for the type, quality, appropriateness, and frequency of facemasks usage from both rural and urban settings in the study area. Frequency distribution tables were used to categorize and describe the observed variables, Chi-square (X2) test was used to check the association between categorical variables. Among the observed individuals, 46.4% used facemasks. The most common facemask used was cloth mask (28.6%). About 16.0% of the participants correctly used their facemasks. The highest usage was observed in the urban location (49.2%). More people used facemasks in urban areas (p<0.001), in the bank (p< 0.001), in the morning (p< 0.001) among the males (p< 0.001), and among the adolescents (p< 0.001). The observed rate of facemask usage, however, may not be good enough to protect the population against the spread of COVID-19, therefore adequate sensitization on the need for proper use of facemasks by the public should be prioritized.

Perceived Exertion during Moderate and Vigorous Physical Activity While Mask Wearing: A Quantitative and Qualitative Pilot Study.

There is limited research examining the perception of exertion during exercise while wearing a facemask. The current study examined if mask usage during moderate or vigorous physical activity (MVPA) changed the self-reported perception of exertion. Seventy-two adults (18 years and older) who were physically active before the COVID-19 pandemic completed a questionnaire that assessed exercise habits and perceptions of mask wearing during MVPA. Participants reported their ratings of perceived exertion (RPE, on a scale of 1–10) while exercising. Wearing a mask resulted in higher RPE vs. no mask during both vigorous (8.4 ± 0.2 vs. 7.4 ± 0.1; p < 0.001) and moderate PA (6.6 ± 0.2 vs. 5.6 ± 0.2; p < 0.001). Qualitative analysis revealed mostly negative perceptions of exercising while wearing a mask, including respiratory issues, detriments to cardiovascular endurance, and general discomfort. A total of 40% of participants reported that they stopped exercising in an indoor/public setting because of a mask mandate in their region. Participants reported participating in less vigorous PA (4.7 ± 0.4 vs. 4.0 ± 0.4 h/week; p = 0.046), but not less moderate PA (3.3 ± 0.3 vs. 3.0 ± 0.3 h/week; p = 0.443) pre vs. during the pandemic. Our study suggests that facemask usage during MVPA causes an increase in RPE and may be one reason for a decrease in vigorous PA during the COVID-19 pandemic.

Physiological effects of exercising at different intensities wearing surgical or double-layer cotton facemasks compared to not wearing a mask

ABSTRACT Since the beginning of the SARS-CoV-2 pandemic, the community use of facemasks has been widely recommended. However, their use during exercise has raised safety concerns. Thus, we compared the physiological differences between exercising wearing a surgical (SM) or a double-layer-cotton (DLC) facemask and not wearing a mask (NM). Sixteen volunteers underwent 4 bouts of cycling-based exercise, which consisted of two different intensities: light-to-moderate and moderate-to-high. Facemasks were used as follows: bout-1 and 4: NM; bout-2: SM or DLC and bout-3: DLC or SM. Ventilatory, metabolic, pulmonary gas exchange (PGE) and perceptual variables were collected. At both exercise intensities compared to NM, both facemasks induced similar ventilatory adaptations, increasing inspiratory time and tidal volume and decreasing breathing frequency. Effect sizes (ES) were larger for DLC than for SM. At moderate-to-high, both facemasks reduced the minute ventilation, whereas at light-to-moderate, it was only seen with DLC. End tidal and mixed CO2 pressures, as well as the difference between them, increased with both facemasks. Again, ES was larger for DLC than SM. No relevant oxygen saturation drop was observed with both facemaks and exercise intensities. A small ES increament in VO2 and VCO2 were seen with both facemasks. Effort perception increased at moderate-to-high for both exercise intensities, buth larger EF were with DLC than SM . DLC increased facial temperature during both exercise intensities. In conclusion, ventilatory adjustments imposed during facemask exercise influenced PGE and metabolic and perceptual changes. Larger ES were mostly seen for DLC than SM. Abbreviations: B f : Breathing frequency.; CPET: Cardiopulmonary exercise test.; CI: Confidence interval.; DLC: Double-layer cotton.; ETCO2: End tidal CO2 pressure.; ES: Effect size.; ΔET-PECO2: Difference between ETCO2 and PECO2.; FMMT: Facemask microclimate temperature.; H R : Heart rate.; IQR: Interquartile range.; NM: No mask.; PECO2: Mixed-expired CO2 pressure.; RER: Respiratory exchange ratio.; RPE: Rate of perceived effort.; SD: Standard deviation.; SM: Surgical Mask.; SpO2: Oxygen saturation.; STP: Subjective thermal perception.; Ti/TTOT: Duty cycle.; VE: Minute ventilation.; VCO2: Carbon dioxide output.; VO2: Oxygen uptake.; V T : Tidal volume.; VT: Ventilatory threshold. Highlights Facemasks affect the breathing pattern by changing the frequency and amplitude of pulmonary ventilation. The augmented ventilatory work increases VO2, VCO2, and RPE and promotes nonconcerning drops in SpO2 and CO2 retention. Increased inspiratory and expiratory pressure can account for the reduction in pulmonary physiological dead space.

Adherence of Facemask During COVID Pandemic Among South Asian CountriesA Web-Based Cross-Sectional Study

Objective: To investigate the facemask adherence rate among South Asian countries and to examine association between face mask adherence and socio-demographic factors.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and duration of study: South Asian countries (Pakistan, India and Bangladesh), from Jul to Sep 2020.&#x0D; Methodology: A total of 1579 individuals of age more than 14 years, of either gender, who had internet accessibility and understood English, participated in the study. The study was designed on Google forms and distributed through social media networks. The three South-Asian countries, Pakistan, India and Bangladesh, were targeted. Data regarding socio-demographics and type of facemask adherence was collected.&#x0D; Results: The mean age of the participants was 31.32 ± 9.83 years. Of all the participants, there were 826 (46.3%) males, and 959 (53.7%) were females. Univariate analysis showed that females, Muslims, education level till graduate, employed, monthly income ≤$300, and Bangladeshis participants had higher odds of face mask adherence (p&lt;0.05). Multivariate analysis showed that females, Muslims, urban residents, secondary level education, employed, family monthly income $100-$300, and Bangladeshis were strongly associated with face mask adherence (p&lt;0.05).&#x0D; Conclusion: Among the three countries, Bangladeshis had higher facemask adherence than Pakistan and India. The sociodemographic factors associated with facemask usage were gender, religion, locality, education, employment status, family monthly income, and nationality.

Evaluating the risk of SARS‐CoV‐2 transmission to bats in the context of wildlife research, rehabilitation, and control

Preventing wildlife disease outbreaks is a priority for natural resource agencies, and management decisions can be urgent, especially in epidemic circumstances. With the emergence of SARS‐CoV‐2, wildlife agencies were concerned whether the activities they authorize might increase the risk of viral transmission from humans to North American bats, but had a limited amount of time in which to make decisions. We describe how decision analysis provides a powerful framework to analyze and reanalyze complex natural resource management problems as knowledge evolves. Coupled with expert judgment and avenues for the rapid release of information, risk assessment can provide timely scientific information for evolving decisions. In April 2020, the first rapid risk assessment was conducted to evaluate the risk of transmission of SARS‐CoV‐2 from humans to North American bats. Based on the best available information and relying heavily on expert judgment, the risk assessment found a small possibility of transmission during summer work activities. Following that assessment, additional knowledge and data emerged, such as bat viral challenge studies, that further elucidated the risks of human‐to‐bat transmission and culminated in a second risk assessment in the fall of 2020. We updated the first SARS‐CoV‐2 risk assessment with new management alternatives and new estimates of little brown bat (Myotis lucifugus) susceptibility, using findings from the fall 2020 assessment and other empirical studies. We found that new knowledge led to an 88% decrease in the median number of bats estimated to be infected per 1,000 encountered when compared to earlier results. The use of facemasks during, or a negative COVID‐19 test or vaccination prior to, bat encounters further reduced those risks. Using a combination of decision analysis, expert judgment, rapid risk assessment, and efficient modes of information distribution, we provided timely science‐based support to decision makers for summer bat work in North America.

A comparison of respiratory particle emission rates at rest and while speaking or exercising

BackgroundThe coronavirus disease-19 (COVID-19) pandemic led to the prohibition of group-based exercise and the cancellation of sporting events. Evaluation of respiratory aerosol emissions is necessary to quantify exercise-related transmission risk and inform mitigation strategies.MethodsAerosol mass emission rates are calculated from concurrent aerosol and ventilation data, enabling absolute comparison. An aerodynamic particle sizer (0.54–20 μm diameter) samples exhalate from within a cardiopulmonary exercise testing mask, at rest, while speaking and during cycle ergometer-based exercise. Exercise challenge testing is performed to replicate typical gym-based exercise and very vigorous exercise, as determined by a preceding maximally exhaustive exercise test.ResultsWe present data from 25 healthy participants (13 males, 12 females; 36.4 years). The size of aerosol particles generated at rest and during exercise is similar (unimodal ~0.57–0.71 µm), whereas vocalization also generated aerosol particles of larger size (i.e. was bimodal ~0.69 and ~1.74 µm). The aerosol mass emission rate during speaking (0.092 ng s−1; minute ventilation (VE) 15.1 L min−1) and vigorous exercise (0.207 ng s−1, p = 0.726; VE 62.6 L min−1) is similar, but lower than during very vigorous exercise (0.682 ng s−1, p < 0.001; VE 113.6 L min−1).ConclusionsVocalisation drives greater aerosol mass emission rates, compared to breathing at rest. Aerosol mass emission rates in exercise rise with intensity. Aerosol mass emission rates during vigorous exercise are no different from speaking at a conversational level. Mitigation strategies for airborne pathogens for non-exercise-based social interactions incorporating vocalisation, may be suitable for the majority of exercise settings. However, the use of facemasks when exercising may be less effective, given the smaller size of particles produced.

Facemasks: Perceptions and use in an ED population during COVID-19.

Facemask use is associated with reduced transmission of SARS-CoV-2. Most surveys assessing perceptions and practices of mask use miss the most vulnerable racial, ethnic, and socio-economic populations. These same populations have suffered disproportionate impacts from the pandemic. The purpose of this study was to assess beliefs, access, and practices of mask wearing across 15 urban emergency department (ED) populations. This was a secondary analysis of a cross-sectional study of ED patients from December 2020 to March 2021 at 15 geographically diverse, safety net EDs across the US. The primary outcome was frequency of mask use outside the home and around others. Other outcome measures included having enough masks and difficulty obtaining them. Of 2,575 patients approached, 2,301 (89%) agreed to participate; nine had missing data pertaining to the primary outcome, leaving 2,292 included in the final analysis. A total of 79% of respondents reported wearing masks "all of the time" and 96% reported wearing masks over half the time. Subjects with PCPs were more likely to report wearing masks over half the time compared to those without PCPs (97% vs 92%). Individuals experiencing homelessness were less likely to wear a mask over half the time compared to those who were housed (81% vs 96%). Study participants reported high rates of facemask use. Respondents who did not have PCPs and those who were homeless were less likely to report wearing a mask over half the time and more likely to report barriers in obtaining masks. The ED may serve a critical role in education regarding, and provision of, masks for vulnerable populations.

Patient knowledge, personal experience, and impact of the first wave of the COVD-19 pandemic in an Irish oncology cohort.

BackgroundOncology patients have had to make many changes to minimise their exposure to COVID-19, causing stress. Despite education, some patients still do not recognise potential COVID symptoms.AimsWe assessed patient knowledge of COVID, and its impact on their behaviours, concerns, and healthcare experience.MethodsA 16-page questionnaire was distributed to 120 oncology patients attending the day unit of a tertiary Irish cancer centre for systemic anti-cancer therapy (May/June 2020). The Irish 7-day COVID incidence during this period ranged from 2 to 11 cases/100,000 people.ResultsOne hundred and one responses were received, 1% had tested positive for COVID, and 31% had undergone testing. Participant insight into their knowledge about COVID and their own behaviour was limited in some cases. Seventy-five percent reported total compliance with restrictions, but many were not fully compliant. Self-reported confidence in knowledge was high, but did not predict demonstrated knowledge. Sixty percent did not recognise two or more symptoms; 40% did not self-identify as high-risk. Patients reported more health-related worry (72%), loneliness (51%), and lower mood (42%) since the pandemic began. Financial toxicity worsened, with increased financial worry (78%), reductions in household income (40%), and increased costs due to lockdown (62%). Use of facemasks introduced new communications barriers for 67% of those with hearing loss.ConclusionsDespite self-reported confidence in knowledge, some patient’s recognition of COVID symptoms and the preventative strategies they should use are not optimal, highlighting the need for further education in this regard. COVID has been a significant stressor for patients and more practical, financial, and psychological supports are needed. Supplementary informationThe online version contains supplementary material available at 10.1007/s11845-022-02999-8.

The Exposure of Workers at a Busy Road Node to PM2.5: Occupational Risk Characterisation and Mitigation Measures

The link between air pollution and health burden in urban areas has been well researched. This has led to a plethora of effective policy-induced monitoring and interventions in the global south. However, the implication of pollutant species like PM2.5 in low middle income countries (LMIC) still remains a concern. By adopting a positivist philosophy and deductive reasoning, this research addresses the question, to what extent can we deliver effective interventions to improve air quality at a building structure located at a busy road node in a LMIC? This study assessed the temporal variability of pollutants around the university environment to provide a novel comparative evaluation of occupational shift patterns and the use of facemasks as risk control interventions. The findings indicate that the concentration of PM2.5, which can be as high as 300% compared to the WHO reference, was exacerbated by episodic events. With a notable decay period of approximately one-week, adequate protection and/or avoidance of hotspots are required for at-risk individuals within a busy road node. The use of masks with 80% efficiency provides sufficient mitigation against exposure risks to elevated PM2.5 concentrations without occupational shift, and 50% efficiency with at least ‘2 h ON, 2 h OFF’ occupational shift scenario.

Facemask Usage Among Pedestrians in Most Crowded Urban Districts of Kabul, Afghanistan, During the Third COVID-19 Wave: An Observational Study.

ABSTRACT.COVID-19 has spread worldwide since its emergence from Wuhan. In countries with a low vaccination rate, the use of facemasks is essential to limit the risk of COVID-19 transmission. We have conducted this study in June 2021 to estimate the prevalence of facemask usage, and investigate the use of different types of facemasks and their distribution among pedestrians in the most crowded urban districts of Kabul during the third COVID-19 wave in Afghanistan. Using a multistage sampling method, a total of 5,000 pedestrians were selected from five most crowded urban districts of the city. The data was gathered by an observational method. The percentage, mean, and standard deviation were used to describe the variables. The χ2 test analysis was used to assess the relationship between two categorical variables. Of the 5,000 observations, the most common age group was 10–39 years with high participation of male (87.2%). A total of 2,013 (40.3%) people used facemasks (95% CI). Females used facemasks significantly more than males (64.6% versus 36.7%, P < 0.001). Among the pedestrians who used a facemask, most of them (88.6%) wore their facemask correctly. In conclusion, the prevalence of facemask use in Kabul was fairly low especially among elderly people (≥ 60 years). Hence, the observed rates probably cannot protect the community against COVID-19. Therefore, it is important to emphasize the public health recommendations via educational programs and national campaigns to support the strict use of facemasks in public places.

Nonpharmaceutical interventions to prevent viral respiratory infection in community settings: an umbrella review.

BackgroundRespiratory viruses pose an important public health threat to most communities. Nonpharmaceutical interventions (NPIs) such as masks, hand hygiene or physical distancing, among others, are believed to play an important role in reducing transmission of respiratory viruses. In this umbrella review, we summarise the evidence of the effectiveness of NPIs for the prevention of respiratory virus transmission in the community setting.ObservationsA systematic search of PubMed, Embase, Medline and Cochrane reviews resulted in a total of 24 studies consisting of 11 systematic reviews and meta-analyses, 12 systematic reviews without meta-analyses and one standalone meta-analysis. The current evidence from these data suggests that hand hygiene is protective against respiratory viral infection. The use of hand hygiene and facemasks, facemasks alone and physical distancing were interventions with inconsistent evidence. Interventions such as school closures, oral hygiene or nasal saline rinses were shown to be effective in reducing the risk of influenza; however, the evidence is sparse and mostly of low and critically low quality.ConclusionsStudies on the effectiveness of NPIs for the prevention of respiratory viral transmission in the community vary in study design, quality and reported effectiveness. Evidence for the use of hand hygiene or facemasks is the strongest; therefore, the most reasonable suggestion is to use hand hygiene and facemasks in the community setting.

Application of Health Belief Model for the assessment of COVID-19 preventive behavior and its determinants among students: A structural equation modeling analysis.

COVID-19 is a new pandemic that poses a threat to people globally. In Ethiopia, where classrooms are limited, students are at higher risk for COVID-19 unless they take consistent preventative actions. However, there is a lack of evidence in the study area regarding student compliance with COVID-19 preventive behavior (CPB) and its predictors. This study aimed to assess CPB and its predictors among students based on the perspective of the Health Belief Model (HBM). A school-based cross-sectional survey was conducted from November to December 2020 to evaluate the determinants of CPB among high school students using a self-administered structured questionnaire. 370 participants were selected using stratified simple random sampling. Descriptive statistics were used to summarize data, and partial least squares structural equation modeling (PLS-SEM) analyses to evaluate the measurement and structural models proposed by the HBM and to identify associations between HBM variables. A T-value of > 1.96 with 95% CI and a P-value of < 0.05 were used to declare the statistical significance of path coefficients. A total of 370 students participated with a response rate of 92%. The median (interquartile range) age of the participants (51.9% females) was 18 (2) years. Only 97 (26.2%), 121 (32.7%), and 108 (29.2%) of the students had good practice in keeping physical distance, frequent hand washing, and facemask use respectively. The HBM explained 43% of the variance in CPB. Perceived barrier (β = - 0.15, p < 0.001) and self-efficacy (β = 0.51, p <0.001) were significant predictors of student compliance to CPB. Moreover, the measurement model demonstrated that the instrument had acceptable reliability and validity. COVID-19 prevention practice is quite low among students. HBM demonstrated adequate predictive utility in predicting CPBs among students, where perceived barriers and self-efficacy emerged as significant predictors of CPBs. According to the findings of this study, theory-based behavioral change interventions are urgently required for students to improve their prevention practice. Furthermore, these interventions will be effective if they are designed to remove barriers to CPBs and improve students' self-efficacy in taking preventive measures.

Uncertainty analysis of facemasks in mitigating SARS-CoV-2 transmission

In the context of global spread of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (SARS-CoV-2), there is a controversial issue on whether the use of facemasks is promising to control or mitigate the COVID-19 transmission. This study modeled the SARS-CoV-2 transmission process and analyzed the ability of surgical mask and N95 in reducing the infection risk with Sobol's analysis. Two documented outbreaks of COVID-19 with no involvers wearing face masks were reviewed in a restaurant in Guangzhou (China) and a choir rehearsal in Mount Vernon (USA), suggesting that the proposed model can be well validated when airborne transmission is assumed to dominate the virus transmission indoors. Subsequently, the uncertainty analysis of the protection efficiency of N95 and surgical mask were conducted with Monte Carlo simulations, with three main findings: (1) the uncertainty in infection risk is primarily apportioned by respiratory activities, virus dynamics, environment factors and individual exposures; (2) wearing masks can effectively reduce the SARS-CoV-2 infection risk to an acceptable level (< 10−3) by at least two orders of magnitude; (3) faceseal leakage can reduce protection efficiency by approximately 4% when the infector is speaking or coughing, and by approximately 28% when the infector is sneezing. This work indicates the effectiveness of non-pharmaceutical interventions during the pandemic, and implies the importance of the synergistic studies of medicine, environment, social policies and strategies, etc., on reducing hazards and risks of the pandemic.

"Responsible" or "Strange?" Differences in Face Mask Attitudes and Use Between Chinese and Non-East Asian Canadians During COVID-19's First Wave.

Early in the COVID-19 pandemic, journalists and scholars noted differences between Asians and North Americans in their support for public mask use. These differences were primarily assumed to be due d to variations in ethnocultural norms and practices. To better ascertain people’s motives for wearing masks and potential cultural differences in these rationales, this comparative, mixed-methods research examines Chinese and non-East Asian Canadians’ mask use attitudes utilizing online group interviews (Study 1) and a nation-wide survey (Study 2) Study 1, conducted in the early stages of the pandemic, captured an ambivalent, yet evolving attitude toward public mask use among the non-East Asian Canadians, which differed from their Chinese counterparts who more uniformly perceived mask use favorably. Study 2, conducted 2 months later, suggests that both groups primarily wore masks for disease protection- and prevention-related reasons. However, age and education appeared to influence the mask wearing frequency of the non-East Asian Canadians, for whom public mask use was less prevalent and normative. The attitudinal differences in public mask use call for targeted strategies to support mask wearing for different ethnocultural groups, which may be achieved partially through enhancing interethnic understanding on the diversified use of and opinions about masks. The findings suggest that favorable social norms, along with evidence-based information campaigns involving personal appeals may encourage greater mask use by the non-East Asian population.

Exit strategies from lockdowns due to COVID-19: a scoping review

IntroductionIn response to the ongoing COVID-19 pandemic, countries have adopted various degrees of restrictive measures on people to reduce COVID-19 transmission. These measures have had significant social and economic costs. In the absence of therapeutics, and low vaccination coverage, strategies for a safe exit plan from a lockdown are required to mitigate the transmission and simultaneously re-open societies. Most countries have outlined or have implemented lockdown exit plans. The objective of this scoping review is to (a) identify and map the different strategies for exit from lockdowns, (b) document the effects of these exit strategies, and (c) discuss features of successful exit strategies based on the evidence.MethodsA five-step approach was used in this scoping review: (a) identifying the research question and inclusion/exclusion criteria; (b) searching the literature using keywords within PubMed and WHO databases; (c) study selection; (d) data extraction; (e) collating results and qualitative synthesis of findings.ResultsOf the 406 unique studies found, 107 were kept for full-text review. Studies suggest the post-peak period as optimal timing for an exit, supplemented by other triggers such as sufficient health system capacity, and increased testing rate. A controlled and step-wise exit plan which is flexible and guided by information from surveillance systems is optimal. Studies recommend continued use of non-pharmaceutical interventions such as physical distancing, use of facemasks, and hygiene measures, in different combinations when exiting from a lockdown, even after optimal vaccination coverage has been attained.ConclusionReviewed studies have suggested adopting a multi-pronged strategy consisting of different approaches depending on the context. Among the different exit strategies reviewed (phase-wise exit, hard exit, and constant cyclic patterns of lockdown), phase-wise exit appears to be the optimal exit strategy.

The Management of Urinary Tract Infections during the COVID-19 Pandemic: What Do We Need to Know?

The landscape of management of urinary tract infections (UTI) is changing rapidly. The COVID-19 pandemic draws our attention to the SARS-CoV-2 management with a subsequent reduced attention on bacterial infections. The COVID-19 diffusion containing procedures, such as use of facemasks and handwashing, have reduced spreading of bacteria and bacterial lung infections. However, a brief analysis of UTI management during the COVID-19 pandemic reveals that the pandemic has changed our management of UTI in a way that violates the principles of antimicrobial stewardship. We therefore remind all urologists and other physicians who manage patients affected by UTI about the importance of continued adherence to antimicrobial stewardship principles during the COVID-19 pandemic.

The Impact of COVID-19 Confinement on Tinnitus and Hearing Loss in Older Adults: Data From the LOST in Lombardia Study.

BackgroundAlthough a direct relationship between tinnitus or hearing difficulties and COVID-19 has been suggested, current literature provides inconsistent results, and no research has been undertaken in older adults.MethodsIn November 2020, we conducted the LOST in Lombardia survey, a telephone-based cross-sectional study on a sample of 4,400 individuals representative of the general population aged ≥65 years from Lombardy region, Northern Italy. Individuals with diagnosed tinnitus and/or hearing loss were asked whether their conditions had improved or deteriorated in 2020 compared to 2019.ResultsOverall, 8.1% of older adults reported a diagnosis of tinnitus and 10.5% of hearing loss. In 2020 compared to 2019, among individuals with tinnitus, those with increasing severity (5.0%) were similar to those decreasing it (5.3%). Among individuals with hearing loss, more people reported an increase (13.6%) than a decrease (3.2%) in their disease severity. No individual with a diagnosis in 2020 of tinnitus (n = 6) or hearing loss (n = 13) had COVID-19. The incidence of tinnitus was lower in 2020 (rate: 14.8 per 10,000 person-years) than in previous years (rate in 1990–2019: 36.0 per 10,000 person-years; p = 0.026). There was no change in the incidence of hearing loss (p = 0.134).ConclusionsIn this large representative sample of older adults, on average neither COVID-19 confinement nor SARS-CoV-2 infection appeared to increase the severity or incidence of tinnitus. The increased severity of hearing difficulties may totally or partially be explained by physiologic deterioration of the condition, or by a misperception due to the use of face-masks.

Outcomes of Neonates Born To Mothers Who Were COVID-19 Positive; An Observational Study from Pakistan

Objective: To assess outcomes of neonates born to mothers who were COVID-19 positive.&#x0D; Study Design: Prospective observational study.&#x0D; Place and Duration of Study: Secondary and Tertiary Care Hospitals of the Armed Forces, Pakistan, from Apr to Aug 2020.&#x0D; Methodology: We studied 106 pregnant women who tested positive for SARS-CoV-2. Stable asymptomatic newborn babies were kept in SARS-CoV-2 specified incubators, at specially designated areas for observation. Nasopharyngeal swabs were taken at first 24 hours and if negative, babies were handed over to clinically stable mothers who were educated regarding use of facemasks and proper hand washing. Neonates who tested positive for SARS-CoV-2 were evaluated for SARS-CoV-2 again at 48 hours and then every 48-72 hours, until found to be negative.&#x0D; Results: Total 106 women were found to be SARS-CoV-2 positive during the study period. All the women delivered singleton babies. Of the 106 babies, 5 (4.71%) were found to be positive for SARS-CoV-2 at 24 hours and only 1 (0.94%) baby was found to be positive at 48 hours and then tested negative at 7th day.&#x0D; Conclusion: Babies born to SARS-CoV-2 mothers were mostly asymptomatic and there was no increased risk of morbidity or mortality to the neonates suffering from the infection.